JMIR Rehabilitation and Assistive Technologies最新文献

{"title":"Use of ChatGPT for Urinary Symptom Management Among People With Spinal Cord Injury or Disease: Qualitative Study.","authors":"Bat-Zion Hose, Amanda K Rounds, Ishaan Nandwani, Deanna-Nicole Busog, Traber Davis Giardina, Helen Haskell, Kelly M Smith, Kristen E Miller","doi":"10.2196/70339","DOIUrl":"https://doi.org/10.2196/70339","url":null,"abstract":"<p><strong>Background: </strong>Individuals with spinal cord injury or disease (SCI/D) experience disproportionately high rates of recurrent urinary tract infections, which are often complicated by atypical symptoms and delayed diagnoses. Patient-centered tools, like the Urinary Symptom Questionnaires for Neurogenic Bladder (USQNB), have been developed to support symptom assessment yet remain underused. Generative artificial intelligence tools such as ChatGPT may offer a more usable approach to improving symptom management by providing real-time, tailored health information directly to patients.</p><p><strong>Objective: </strong>This study explores the role of ChatGPT (version 3.5) in supporting urinary symptom management for individuals with SCI/D, focusing on its perceived accuracy, usefulness, and impact on health care engagement and self-management practices.</p><p><strong>Methods: </strong>A total of 30 individuals with SCI/D were recruited through advocacy groups and health care networks. Using realistic, scenario-based testing derived from validated tools for symptom management with SCI/D, such as the USQNB, participants interacted with ChatGPT to seek advice for urinary symptoms. Follow-up interviews were conducted remotely to assess individuals' experiences using ChatGPT for urinary symptom management. Data were analyzed using inductive content analysis, with themes refined iteratively through a consensus-based process.</p><p><strong>Results: </strong>People with SCI/D reported high levels of trust in ChatGPT's recommendations, with all 30 participants agreeing or strongly agreeing with the advice provided. ChatGPT's responses were perceived as clear and comparable to professional medical advice. Participants mentioned concerns about the lack of sources and integration with patient-specific data. ChatGPT influenced individuals' decision-making by supporting symptom assessment and guiding participants on when to seek professional care or pursue self-management strategies.</p><p><strong>Conclusions: </strong>ChatGPT is a promising tool for symptom assessment and managing chronic conditions such as urinary symptoms in individuals with SCI/D. While ChatGPT enhances accessibility to health information, further research is needed to improve its transparency and integration with personalized health data to be a more usable tool in making informed health decisions.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e70339"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smart Wearable Technologies for Balance Rehabilitation in Older Adults at Risk of Falls: Scoping Review and Comparative Analysis.","authors":"Brooke Nairn, Vassilios Tsakanikas, Becky Gordon, Efterpi Karapintzou, Diego Kaski, Dimitrios I Fotiadis, Doris-Eva Bamiou","doi":"10.2196/69589","DOIUrl":"https://doi.org/10.2196/69589","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Falls among older adults are a significant public health concern, often leading to severe injuries, decreased quality of life, and substantial health care costs. Smart wearable technologies for balance rehabilitation present a promising avenue for addressing the falls epidemic, capable of providing detailed objective movement data, engaging visuals, and real-time feedback. With the recent and rapid evolution of innovative technologies, including artificial intelligence (AI), augmented reality (AR) or virtual reality (VR), and motion tracking, there is a need to evaluate the market to identify the most effective and accessible smart balance systems currently available.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to evaluate the current landscape of smart wearable technology systems for balance rehabilitation in older adults at risk of falls. In addition, it aims to compare market-available systems to the telerehabilitation of balance clinical and economic decision support system (TeleRehab DSS), a recently developed smart balance system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A scoping review and strengths, weaknesses, opportunities, and threats (SWOT) analysis was completed, exploring the landscape of smart balance systems in older adults at risk of falls. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, electronic databases PubMed, MEDLINE, and Cochrane were systematically searched for articles in English from July 1, 2014, to July 1, 2024. Gray literature searches of relevant institutions and web pages were also conducted. The database search and commercial systems were then compared against the TeleRehab DSS in a SWOT analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The scoping review yielded 17 systems that met the inclusion criteria; 10 investigational systems and 7 commercially available systems. Out of 10 studies, only 1 reported the use of intelligent learning or AI, 8 studies reported the use of motion tracking, and 9 studies used virtual reality. Of the studies incorporating motion tracking, 3 provided feedback as either visual or auditory. All but 2 studies reported the use of gamification, and 7 studies incorporated balance exercises. In total, 2 studies reported remote delivery, with 5 being clinician-supervised and 4 providing a clinician report. The SWOT analysis of TeleRehab DSS against the 7 market-available smart balance systems revealed several unique advantages, including personalized therapy with AI-DSS, AR for real-world interaction, enhanced clinician involvement, and comprehensive data analytics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The findings from this scoping review highlight the rapid evolution of smart balance systems, yet significant gaps remain in AI integration, remote accessibility, and clinician-driven data analytics. Despite limitations such as cost, accessibility, and user training requirements, TeleRe","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e69589"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New, Portable Orofacial Manometer for Measuring Tongue Strength and Endurance in Children: Laboratory-Based Validity Study.","authors":"Rizky Kusuma Wardhani, Luh Karunia Wahyuni, Widjajalaksmi Kusumaningsih, Sarworini Bagio Budiardjo, Prasandhya Astagiri Yusuf, Sri Mardjiati Mei Wulan, Aria Kekalih, Titis Prawitasari, Sawitri Darmiati, Boya Nugraha","doi":"10.2196/68967","DOIUrl":"https://doi.org/10.2196/68967","url":null,"abstract":"<p><strong>Background: </strong>An accurate tongue strength and endurance assessment is necessary for pediatric dysphagia. TongueFit is a new, portable orofacial manometer for measuring tongue strength and endurance and a game-based training app for children.</p><p><strong>Objective: </strong>This study aimed to test the validity of TongueFit compared with a standard manometer as the current gold standard for measuring air pressure.</p><p><strong>Methods: </strong>This laboratory study compared TongueFit and a standard manometer as the gold standard for measuring air pressure. This study was conducted in 3 different experimental conditions. The first experiment compared TongueFit and the standard manometer using a force tester (MCT-2150), with pressure controlled by MSatLite software. The second and third experiments involved 2-cm and 3-cm bulbs between the 2 devices. This study used Lin concordance correlation to measure the level of agreement.</p><p><strong>Results: </strong>There was a mean absolute difference of 0.005 kilopascals (kPa) between the TongueFit and the standard manometer (n=35, ρC=1). Statistical analysis showed perfect agreement correlation (ρC=1). By using the 2-cm bulb, TongueFit's mean was 0.007 kPa lower, also showing perfect agreement (ρC=1). Furthermore, using the 3-cm bulb, results showed almost perfect agreement (ρC=0.999) with the TongueFit's mean, which was 0.044 kPa lower.</p><p><strong>Conclusions: </strong>This study confirms the high validity of TongueFit as an orofacial manometer compared with a standard manometer, with negligible mean differences, as well as near-perfect and perfect agreement in the experiments. These results confirm that TongueFit is a valid and accurate tool for assessing tongue strength.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68967"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Method for Custom-Contoured Cushion Fabrication Based on Pressure Mapping for Wheelchair Users to Prevent Pressure Ulcers: Feasibility Quasi-Experimental Study.","authors":"Alma De León-Hernández, Adriana Martínez-Hernández, Isabel Bolivar-Tellería, Andrea Bosch-Sánchez, María Fernanda Cabrera-Padilla, Carlos Omar López-López","doi":"10.2196/68612","DOIUrl":"https://doi.org/10.2196/68612","url":null,"abstract":"<p><strong>Background: </strong>Pressure ulcers constitute a major health care burden, characterized by significant morbidity, diminished quality of life, and elevated treatment costs. Wheelchair users are predisposed to pressure ulcers due to sustained ischial and sacral interface pressures resulting from prolonged periods of sitting. Implementation of pressure-relieving interventions, including specialized seating systems engineered to redistribute load and augment the weight-bearing surface area, is critical for mitigating the risk of pressure ulcers.</p><p><strong>Objective: </strong>This study aimed to evaluate a methodology for the custom fabrication of pressure relief cushions, through the user-cushion interface pressure mapping to reduce high-pressure areas and increase contact area in wheelchair users.</p><p><strong>Methods: </strong>First, a validation study was carried out with 7 healthy volunteers. The pressure was determined with an FSA sensor (BodiTrak BT1510, Vista Medical Manufactures), and the cushion profile was obtained through a linear relation with pressure values. In the second phase, 10 cushions for wheelchair users were manufactured and tested. The resulting data from buttock pressure using a flat foam, Jay X2 (gel-foam), ROHO high profile (air), and customed-contoured cushions were analyzed and compared using the following 4 variables: peak pressure, peak pressure index, mean pressure, and contact area.</p><p><strong>Results: </strong>In the validation study, the statistically significant difference between the flat and the custom-contoured cushion showed a better performance in pressure relief for the custom cushion (mean pressure 27.3, SD 4.5 mm Hg and 34.6, SD 3.5 mm Hg; P<.001). Regarding the study with wheelchair users, custom-contoured cushions had lower peak pressure (mean 91.3, SD 36 mm Hg), peak pressure index (mean 69.5, SD 33.7 mm Hg), and mean pressure (34.2, SD 17.4 mm Hg) against flat, Jay X2, and ROHO high profile cushions (P<.005). The contact area (mean 1457.6, SD 254.1 cm2) was greater for the contoured cushion (P<.001) than for flat and ROHO high profile (Permobile) cushions; nevertheless, it was not significantly different from Jay X2 (P=.59).</p><p><strong>Conclusions: </strong>The main finding is that the buttock pressure mapping method produces custom-contoured cushions that, compared with commercial cushions, have good pressure distribution and increased contact area. These results suggest that pressure mapping is a good alternative for manufacturing affordable custom-contoured cushions that can prevent the development of pressure ulcers.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68612"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Compassionate Care in Virtual Rehabilitation: Qualitative Study.","authors":"Parminder Flora, Angela Tobia, Lee Verweel, Bernice Lau, Janet Campbell, Arezoo Eshraghi, Steven Dilkas, Roger Goldstein, Patricia Raulino, Crystal MacKay","doi":"10.2196/59157","DOIUrl":"https://doi.org/10.2196/59157","url":null,"abstract":"<p><strong>Background: </strong>Virtually delivered health care services can offer numerous benefits, and the demand for virtual care continues to grow among subgroups facing mobility challenges. The experience of compassion in health care is linked to patient satisfaction and clinical outcomes; however, this link in virtual rehabilitation settings is underexplored.</p><p><strong>Objective: </strong>The objectives of this study were to explore what compassionate care means to rehabilitation patients in a virtual rehabilitation context and explore patients' experiences of how the technology associated with virtual rehabilitation impacted their experience of care.</p><p><strong>Methods: </strong>We conducted one-on-one semistructured qualitative interviews with patients with limb loss and chronic obstructive pulmonary disease. A reflexive thematic analysis approach was used to generate domain summaries and initial themes across the sample. Themes were generated following analytic work over a series of discussions within the research team.</p><p><strong>Results: </strong>Sixteen interviews were conducted. Four themes illustrating participants' perceptions of compassionate care were generated: (1) features of compassionate care include feeling valued, connected, and cared for by the health care provider; (2) threats to compassionate care in virtual rehabilitation; (3) facilitating compassion in virtual rehabilitation through preparation; and (4) benefits of virtual care.</p><p><strong>Conclusions: </strong>Patient perceptions of compassionate care in a virtual rehabilitation setting may be impacted by the behaviors and communication of providers. Provider training and preparation and the personal connections formed with their patients may impact compassionate care experiences.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e59157"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stakeholders and Contextual Factors in the Implementation of Assistive Robotic Arms for Persons With Tetraplegia: Deductive Content Analysis of Focus Group Interviews.","authors":"Vera Fosbrooke, Marco Riguzzi, Anja M Raab","doi":"10.2196/65759","DOIUrl":"https://doi.org/10.2196/65759","url":null,"abstract":"<p><strong>Background: </strong>Tetraplegia imposes significant challenges on affected individuals, caregivers, and health care systems. Assistive technologies (ATs) such as assistive robotic arms have been shown to improve the quality of life of persons with tetraplegia, fostering independence in daily activities and reducing caregiver burden. Despite potential benefits, the integration of AT innovations into daily life remains difficult. Implementation science offers a systematic approach to bridge this know-do gap.</p><p><strong>Objective: </strong>This study aimed to (1) identify and involve relevant stakeholders; (2) identify relevant contextual factors (barriers and facilitators); and (3) suggest a general outlook for the implementation of AT, specifically an assistive robotic arm, into the everyday private lives of individuals with tetraplegia in Switzerland.</p><p><strong>Methods: </strong>A qualitative design was used, involving 3 semistructured online focus group interviews with 8 stakeholder groups, including persons with tetraplegia as well as those who could provide perspectives on engineering or technology, legal matters, nursing or care, therapy, social counseling, social insurance, and political considerations. The interviews were analyzed using the Focus Group Illustration Mapping tool, and the data were aligned with the domains of the Consolidated Framework for Implementation Research.</p><p><strong>Results: </strong>3 focus group interviews comprising 22 participants were conducted, and data were mapped onto 21 constructs across the Consolidated Framework for Implementation Research domains. Identified barriers were customization to users' needs, safety concerns, and financing issues for the high AT costs. The collaboration with different stakeholders, including those who provided perspectives on political engagement, proved crucial. Identified facilitators included the enhancement of autonomy for persons with tetraplegia, improvement of quality of life, reduction of caregiver dependency, and addressing health care labor shortages. The implementation outlook involved the formation of an experienced team and the development of an implementation plan using hybrid type 1 and type 2 designs that incorporate both qualitative and quantitative implementation and innovation outcomes.</p><p><strong>Conclusions: </strong>Robotic arms offer promising benefits in terms of improved participation for users, while high costs and regulatory complexities as to who will assume these costs limit their implementation. These findings highlight the complexities involved in implementing AT innovations and the importance of addressing contextual factors. A specific framework for the implementation of AT is needed to ensure the successful integration in Switzerland and other countries with comparable social and health insurance systems.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e65759"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Gait Kinematics With Ramp and Stair Ascent and Descent Revealed by Markerless Motion Capture in Simulated Living Space: Test-Retest Reliability Study.","authors":"Daiki Shimotori, Kenji Kato, Tatsuya Yoshimi, Izumi Kondo","doi":"10.2196/66886","DOIUrl":"10.2196/66886","url":null,"abstract":"<p><strong>Background: </strong>In recent years, there has been an increasing demand for markerless motion capture systems, which are being widely used in biomechanical and clinical research. Furthermore, by using a markerless motion capture system in a laboratory environment that mimics living spaces, the data acquired on various activities of daily living, such as level walking, ramp walking, and stair ascent and descent, should more closely resemble that of real-life activities. However, the absolute reliability of gait parameters in this context is still unclear.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the reliability of a markerless motion capture system in assessing the ascent and descent of ramps and stairs during walking in a simulated living space.</p><p><strong>Methods: </strong>A total of 21 healthy participants performed level walking, ramp and stair ascent and descent on two separate days, with at least a 24-hour interval between sessions. Joint angles were measured using 27 synchronized cameras with a markerless motion capture application, Theia3D (Theia Markerless Inc), and analyzed in Visual3d for all planes of motion at the hip-, knee-, and ankle-joints. The absolute reliability of day-to-day reproducibility was assessed using full-curve analysis (root mean square difference [RMSD]) and discrete point analysis of gait events using the standard error of measurement (SEM). SEM was calculated only for level walking and ramp ascent and descent, where gait events were correctly detected.</p><p><strong>Results: </strong>The SEM values for level walking and ramp ascent and descent were all below the 5-degree threshold. However, while RMSD values were generally below 5°, this threshold was exceeded for knee-joint flexion-extension angles during ramp ascent and stair ascent (5.07° and 5.64°, respectively).</p><p><strong>Conclusions: </strong>The markerless motion capture system in the living laboratory setting demonstrated a high degree of accuracy for various environments and gait types. The low SEM values obtained indicate good reliability for joint angle measurements across different days. The slightly higher RMSD values for knee-joint angles during ramp and stair ascent may reflect the system's ability to capture the adaptations in joint kinematics in response to changes in gait conditions. These measurements in a living laboratory environment validated the absolute reliability of various gait parameters not only in level walking but also in ramp and stair ascent and descent. The findings suggest potential clinical applications and research opportunities, including the development of assistive devices and robots, using markerless motion capture in more natural living situations, rather than in controlled environments.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e66886"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' Expectations for App-Based Therapy in Knee Osteoarthritis: User-Centered Design Approach.","authors":"Pika Krištof Mirt, Karmen Erjavec, Sabina Krsnik, Petra Kotnik, Hussein Mohsen","doi":"10.2196/64607","DOIUrl":"10.2196/64607","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Knee osteoarthritis (KOA) requires long-term treatment that faces significant barriers, including inadequate physiotherapy services, especially in Slovenia and comparable European countries. Mobile health apps offer a promising solution to improve accessibility and adherence to KOA treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to identify expectations of patients with KOA for app-based therapy, determine the functional requirements, and assess the main barriers and benefits of using mobile apps for KOA management. It also examined these factors about demographic data (gender, age, and education level) and motivation to perform knee exercises.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A mixed methods approach was used, integrating quantitative data from a structured questionnaire and qualitative data from in-depth interviews. The purposive sample comprised 82 patients with symptomatic KOA graded 1-3 on the Kellgren-Lawrence scale, excluding those with cognitive impairments, wheelchair dependency, significant comorbidities, or language barriers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The analysis revealed that 53.7% (44/82) of patients preferred smartphones, while 40.2% (33/82) favored PCs for remote KOA management, citing accessibility and convenience. Exercise videos received the highest rating (µ=9.45), followed by goal setting and tracking (µ=8.95) and regular e-messages (µ=8.83). Telephone consultations with physiotherapists were also highly valued (µ=8.41). Significant differences were observed in the perceived importance of key disease information (F9=2.077; P=.04) and exercise videos (F9=2.788; P=.05) based on motivation levels but not by gender, age, or education. Perceptions of the appropriate duration of physical activity varied with motivation levels (F9=2.490; P=.02) but not with demographic factors. Men rated ease of use (4.93 vs 4.71; F1=3.961; P=.05) and the clarity of the exercise flow display higher than women. The most significant barrier was inaccurate disease information (µ=3.96), with notable differences across age groups. Younger participants (younger than 40 years) and those aged 51-60 years expressed concerns about time management and information accuracy. Patients highlighted the ability to rewatch exercises as a key app feature, while time efficiency and improved access to physiotherapists were highly valued for convenience. Enhanced communication and accurate information were essential for building trust and ensuring effective treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Mobile health apps for KOA management should be designed with a user-centered approach, prioritizing accessibility, motivation, and effective communication. Key functionalities include high-quality exercise videos, goal setting, symptom tracking, and regular electronic reminders. Mitigating user-reported barriers and integrating age-specific adaptations can enhance adherence and therapeutic outcomes. The findings highlig","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e64607"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-Designed Digital Device for Tracking Rehabilitation Dosage in a Clinical Environment After Stroke: Mixed Methods Validity and Feasibility Study.","authors":"Fiona Boyd, Gillian Sweeney, Mark Barber, Elaine Forrest, Mark Dunlop, Andrew Kerr","doi":"10.2196/68129","DOIUrl":"10.2196/68129","url":null,"abstract":"<p><strong>Background: </strong>In 2023, the National Clinical Guidelines for Stroke revised the recommended daily multidisciplinary therapy dose from 45 minutes per therapy to 3 hours of therapy overall. To monitor the achievement of these guidelines, there is a need for accurate measurement. This study introduces a novel co-designed digital dosage tracking system that uses Near Field Communication technology to log rehabilitation activities and demonstrates its feasibility and accuracy in a clinical setting through comparison with the current clinical method of manual recording.</p><p><strong>Objective: </strong>This study aimed to assess the validity, feasibility, and usability of a novel co-designed digital tracker using Near Field Communication technology to automatically log rehabilitation dosage in people with stroke history, providing an objective and low-burden solution for clinical environments.</p><p><strong>Methods: </strong>This pilot mixed methods study included 2 phases. Phase 1 involved a usability trial with 9 participants conducted at a university research center, assessing usability with the System Usability Scale (SUS) and Intrinsic Motivation Inventory (IMI). Phase 2 consisted of a clinical trial in a National Health Service stroke ward with 15 inpatients, comparing the digital tracker with manual therapist recordings for validity and feasibility using paired t tests, Cohen d, and Bland-Altman plots. An acceptable discrepancy range was set at ±5%-10%.</p><p><strong>Results: </strong>The digital tracker demonstrated high usability with a mean SUS score of 91.43 (SD 9.53) and strong user satisfaction (IMI score 6.29/7, SD 1.50). Clinical trial results showed a strong agreement between the digital and manual methods (t206=-1.60; P=.11; Cohen d=-0.06), with a small mean time discrepancy of 1.23 (SD 11.01) minutes across 207 activities. The Bland-Altman plot indicated good accuracy and consistency between methods, with limits of agreement within the clinically acceptable range.</p><p><strong>Conclusions: </strong>The co-designed digital tracker has been shown to agree with a manual method for recording rehabilitation dosage. This development presents the opportunity for objective, automated, and low-burden recording of rehabilitation dose to support prescription, monitoring, and research.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68129"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Clinical Decision Support for Interdisciplinary Multimodal Chronic Musculoskeletal Pain Treatment: Prospective Pilot Study of Patient Assessment and Prognostic Profile Validation.","authors":"Fredrick Zmudzki, Rob J E M Smeets, Jan S Groenewegen, Erik van der Graaff","doi":"10.2196/65890","DOIUrl":"10.2196/65890","url":null,"abstract":"<p><strong>Background: </strong>Chronic musculoskeletal pain (CMP) impacts around 20% of people globally, resulting in patients living with pain, fatigue, restricted social and employment capacity, and reduced quality of life. Interdisciplinary multimodal pain treatment (IMPT) programs have been shown to provide positive and sustained outcomes where all other interventions have failed. IMPT programs combined with multidimensional machine learning predictive patient profiles aim to improve clinical decision support and personalized patient assessments, potentially leading to better treatment outcomes.</p><p><strong>Objective: </strong>We aimed to investigate integrating machine learning with IMPT programs and its potential contribution to clinical decision support and treatment outcomes for patients with CMP.</p><p><strong>Methods: </strong>This prospective pilot study used a machine learning prognostic patient profile of 7 outcome measures across 4 clinically relevant domains, including activity or disability, pain, fatigue, and quality of life. Prognostic profiles were created for new IMPT patients in the Netherlands in November 2023 (N=17). New summary indicators were developed, including defined categories for positive, negative, and mixed prognostic profiles; an accuracy indicator with high, medium, and low levels based on weighted true- or false-positive values; and an indicator for consistently positive or negative outcomes. The consolidated reporting guidelines checklist for prognostic machine learning modeling studies was completed to provide transparency of data quality, model development methodology, and validation.</p><p><strong>Results: </strong>The machine learning IMPT prognostic patient profiles demonstrated high accuracy and consistency in predicting patient outcomes. The profile, combined with extended new prognostic summary indicators, provided improved identification of patients with predicted positive, negative, and mixed outcomes, supporting more comprehensive assessment. Overall, 82.4% (14/17) of prognostic patient profiles were consistent with clinician assessments. Notably, clinician case notes indicated the stratified prognostic profiles were directly discussed with around half (8/17, 47.1%) of patients. Clinicians found the prognostic patient profiles helpful in 88.2% (15/17) of initial IMPT assessments to support shared clinician and patient decision-making and discussion of individualized treatment planning.</p><p><strong>Conclusions: </strong>Machine learning prognostic patient profiles showed promising contributions for IMPT clinical decision support and improving treatment outcomes for patients with CMP. Further research is needed to validate these findings in larger, more diverse populations.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e65890"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}